Oxford Assess and Progress: Clinical Dentistry PDF
Preview Oxford Assess and Progress: Clinical Dentistry
OXFORD ASSESS AND PROGRESS Series Editors Katharine Boursicot Director, Health Professional Assessment Consultancy (HPAC) Honorary Reader in Medical Education St George’s, University of London David Sales Consultant in Medical Assessment OXFORD ASSESS AND PROGRESS Also available and forthcoming titles in the Oxford Assess and Progress series Clinical Dentistry Nicholas Longridge, Peter Clarke, Raheel Aftab, and Tariq Ali Clinical Medicine, Third Edition Dan Furmedge and Rudy Sinharay Clinical Specialties, Third Edition Luci Etheridge and Alex Bonner Clinical Surgery Neil Borley, Frank Smith, Paul McGovern, Bernadette Pereira, and Oliver Old Emergency Medicine Pawan Gupta Medical Sciences Jade Chow and John Patterson Psychiatry Gil Myers and Melissa Gardner Situational Judgement Test, Third Edition David Metcalfe and Harveer Dev OXFORD ASSESS AND PROGRESS Clinical Dentistry Nicholas Longridge BSc (Hons), BDS (Hons), MFDS RCSEd Academic Clinical Fellow/ Specialty Registrar in Endodontics Liverpool University Dental Hospital, United Kingdom Peter Clarke BDS (Hons), MFDS RCSP (Glasg) Specialty Registrar in Restorative Dentistry University Dental Hospital of Manchester, United Kingdom Raheel Aftab BDS, MJDF RCSEng, PgCert Primary Dental General Dental Practitioner, Educational Supervisor Kent, United Kingdom Tariq Ali MB ChB, MRCS, DOHNS RCSEng, MRCEM, BDS, MJDF RCSEng Associate Lecturer, Faculty of Medicine, University of Queensland Registrar Oral and Maxillofacial Surgery Queensland, Australia 1 1 Great Clarendon Street, Oxford, OX2 6DP, United Kingdom Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries © Oxford University Press 209 The moral rights of the authors have been asserted First Edition published in 209 Impression: All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this work in any other form and you must impose this same condition on any acquirer Published in the United States of America by Oxford University Press 98 Madison Avenue, New York, NY 006, United States of America British Library Cataloguing in Publication Data Data available Library of Congress Control Number: 20993586 ISBN 978– 0– 9– 88257– 3 Printed and bound in China by C&C Offset Printing Co., Ltd. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-t o- date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-p regnant adult who is not breast- feeding Links to third party websites are provided by Oxford in good faith and for information only. Oxford disclaims any responsibility for the materials contained in any third party website referenced in this work. v Series editor preface The Oxford Assess and Progress series is a groundbreaking development in the extensive area of self-a ssessment texts available for dental and medical students. The questions were specifically commissioned for the series, written by practising clinicians, extensively peer-r eviewed by stu- dents and their teachers, and quality-a ssured to ensure that the material is up- to- date, accurate, and in line with modern testing formats. The series has a number of unique features and is designed to be as much a formative learning resource as a self-a ssessment one. The ques- tions are constructed to test the same clinical problem-s olving skills that we use as practising clinicians, rather than only to test theoretical know- ledge. These skills include: ● gathering and using data required for clinical judgement ● choosing the appropriate examination and investigations ● applying knowledge and interpreting findings ● demonstrating diagnostic skills ● ability to evaluate undifferentiated material ● ability to prioritize ● making decisions and demonstrating a structured approach to decision- making. Each question is bedded in reality and is typically presented as a clinical scenario, the content of which has been chosen to reflect the common and important conditions that most dentists and doctors are likely to encounter both during their training and in exams! The aim of the series is to build the reader’s confidence in recognizing important symptoms and signs and suggesting the most appropriate investigations and management, and, in so doing, to aid the development of a clear approach to patient management which can be transferred to the clinical environment. The content of the series has deliberately been pinned to the relevant Oxford Handbook but, in addition, has been guided by a blueprint which reflects the themes identified in the General Dental Council’s Preparing for practice— Dental teams learning outcomes for registration, including an evidence- based approach to learning, along with clinical, managerial, and professionalism scenarios. Particular attention has been paid to giving learning points and con- structive feedback on each question, using clear fact- or evidence- based explanations as to why the correct response is right and why the incorrect responses are less appropriate. The question editorials are clearly referenced to the relevant sections of the accompanying Oxford Handbook and/ or more widely to medical literature or guidelines. They are designed to guide and motivate the reader, being multi- purpose in nature and covering, e.g. exam technique, approaches to difficult subjects, and links between subjects. SERIES EDITOR PREFACE vi Another unique aspect of the series is the element of competency progression from being a relatively inexperienced student to being a more experienced junior dentist. We have suggested the following four degrees of difficulty to reflect the level of training, so that the reader can monitor their own progress over time: ● graduate should know ★ ● graduate nice to know ★★ ● foundation dentist should know ★★★ ● foundation dentist nice to know ★★★★ We advise the reader to attempt the questions in blocks as a way of testing their knowledge in a clinical context. The series can be treated as a dress rehearsal for life as a clinician by using the material to hone clin- ical acumen and build confidence by encouraging a clear, consistent, and rational approach, proficiency in recognizing and evaluating symptoms and signs, making a rational differential diagnosis, and suggesting appro- priate investigations and management. Adopting such an approach can aid not only success in examin- ations, which really are designed to confirm learning, but also— more importantly— being a good dentist and doctor. In this way, we can deliver high- quality and safe patient care by recognizing, understanding, and treating common problems, but at the same time remaining alert to the possibility of less likely, but potentially catastrophic, conditions. David Sales and Kathy Boursicot Series Editors vii A note on single best answer questions Single best answer questions are currently the format of choice being widely used by most undergraduate and postgraduate knowledge tests, and therefore, the questions in this book follow this format. Single best answer questions have many advantages over other machine- markable formats, such as extended matching questions (EMQs), notably the breadth of sampling or content coverage that they afford. Briefly, the single best answer or ‘best of five’ question presents a problem, usually a clinical scenario, before presenting the question itself and a list of five options. These consist of one correct answer and four incorrect options, or ‘distractors’, from which the reader has to choose a response. All of the questions in this book, which are typically based on an evalu- ation of symptoms, signs, results of investigations, or material inter- actions, either as single entities or in combination, are designed to test reasoning skills, rather than straightforward recall of facts, and utilize cog- nitive processes similar to those used in clinical practice. The peer- reviewed questions are written and edited in accordance with contemporary best assessment practice, and their content has been guided by a blueprint pinned to all areas of the General Dental Council’s document Preparing for practice— Dental teams learning outcomes for regis- tration, which ensures comprehensive coverage. The answers and their rationales are evidence- based and have been reviewed to ensure that they are absolutely correct. Incorrect options are selected as being plausible, and indeed they may appear correct to the less knowledgeable reader. When answering questions, the reader may wish to use the ‘cover’ test, in which they read the scenario and the question but cover the options. Kathy Boursicot and David Sales Series Editors ix Author preface Dental school can be a challenging and emotional time. The breadth of experiences gained both professionally and socially cannot be rivalled, and in hindsight, most come to look upon their time at university as a thoroughly enjoyable experience. Needless to say, preparing for the multitude of examinations and assessments throughout the programme is never a favourite pastime, but a necessary evil nonetheless. Whether it is the prospect of finals or postgraduate examinations on the horizon, we remember the constant pressure to read and revise only too well. Our own experiences frequently involved discussing a range of possible questions which lacked informative answers. This led us to the Oxford Assess and Progress Series and to the production of this book. The Oxford Handbook of Clinical Dentistry (OHCD) was never far from reach during dental school, and within this book, we have attempted to provide a series of single best answer questions that link the OHCD with real- life practical scenarios to test reasoning and application of know- ledge. Where possible, recommended reading and references to seminal papers have been provided to encourage further reading and to support evidence- based practice. Within the book, we have selected Keywords, where relevant, to help highlight specific clues or words that can assist with recall in those high-p ressure situations. All questions have been written and peer- reviewed by clinicians working within each specialty, and we have endeavoured to provide in-d epth justification for correct and incorrect answers. Undoubtedly, some topics will remain conten- tious, but, where necessary, we have explained our reasoning and hope that this highlights the ‘grey’ areas in many dental scenarios. Chapters are formatted by specialty, and we have attempted to maintain a clear focus on clinically oriented scenarios that will be beneficial for finals and beyond. A selection of questions on ‘Law and ethics’ have been written and combined into the clinical specialty for which they are relevant. As previously mentioned, we started this book with the hope of providing an informative and supportive revision tool that encour- ages further reading and evidence-b ased practice. Looking back, we all remember dental school with fond memories, and we hope that you find this book useful and wish you the very best for your finals and future careers beyond. Nicholas Longridge, Peter Clarke, Raheel Aftab, and Tariq Ali
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